Jacksonville Cosmetic Surgry Center
Clinic/Center, Ambulatory Surgical in Jacksonville, FL. Organization (NPI-2).
NPI number1174635148
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1174635148
- Entity type
- Organization (NPI-2)
- Legal business name
- Jacksonville Cosmetic Surgry Center
- Organization subpart
- No
- Enumeration date
- Aug 31, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QA1903X | Clinic/Center, Ambulatory Surgical | – | – | Yes |
Other names
- Plastic And Cosmetic Surgery Center (Former Legal Business Name)
Practice location
820 Prudential DrSuite 702
Jacksonville, FL 32207-8210
Phone 904-399-5061 · Fax 904-399-5062
Mailing address
820 Prudential DrSuite 702
Jacksonville, FL 32207-8210
Phone 904-399-5061 · Fax 904-399-5062
Authorized official
A.H. Nezami
President
9043995061
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